Antibiotic development and the changing role of the pharmaceutical industry

There is a complex relationship between the pharmaceutical industry and society. The industry, patients, physicians, regulators and politicians are all driven by their own agendas and are subject to sometimes very powerful influences [31]. The primary aims of pharmaceutical companies are, through research, development, production and marketing, to provide new medicines to improve the health of populations [24] and, as any other industry, to run a profitable business. Unfortunately, large multinational companies spend more time and financial resources on the generation and dissemination of medical information than they do on researching and developing new treatments [11,17]. Additionally, the proportion of annual revenues that these companies keep as profit is systemically larger than that invested in research and development (R&D) [42]. The pharmaceutical industry is, of course, accountable to its shareholders, but also to society at large. This latter role often seems to be forgotten by the industry, witness its inappropriate pricing of drugs, its large-scale indifference to the needs of developing countries, and the imbalance between true innovation and promotional activity [17]. Additionally, drug regulation bodies should be sufficiently robust to protect society from drugs that are unsafe, ineffective or unnecessary, but the many ways in which the industry can influence governments and regulatory agencies suggest another imbalance [1]. Clearly, the reconciliation of commercial goals and the interest of the public remains a challenge for today’s society and for the industry. The increasing number of reports about emerging multi-drug resistant bacteria and the lack of genuinely new classes of antibacterial drugs suggest that we may face the beginning of a post-antibiotic era. The unmet need for new therapies to treat bacterial infections caused by drug-resistant microorganisms should be a strong incentive to boost antibacterial R&D. However, the pharmaceutical industry is gradually deserting the field of antibiotic research and focusing its efforts on chronic diseases that require life-long daily treatment or on manifestations such as baldness or inadequate sexual performance, which have come to be considered as “diseases” deserving specific treatments [13]. Every year, many new potential antibacterial drugs are presented at scientific conferences, but very few seem to be interesting enough for the pharmaceutical industry. The problem is accentuated by large pharmaceutical companies’ insisting that they need financial incentives before they can re-start their antibacterial drug development